O15/151 Impact of post-thrombectomy isolated subarachnoid hemorrhage and other types of intracranial hemorrhage on neurological outcomes in patients with anterior circulation ischemic stroke – reperfusion grade determines

Introduction

Subarachnoid hemorrhage is a common finding, ranging from 5.2% to 15.2% in ischemic stroke patients after mechanical thrombectomy.

Aim of Study

We aimed to evaluate neurological outcomes in patient groups without intracranial hemorrhage (non-ICH), with isolated subarachnoid hemorrhage (i-SAH) and with other types of intracranial hemorrhage (o-ICH) than i-SAH after thrombectomy.

Methods

Stroke data from 2018 to 2021 in a tertiary care centre were retrospectively analysed. Patients with anterior large vessel occlusion were included. Neurological impairment was assessed using NIHSS. Outcomes were compared using Mann-Whitney-U-test.

Results

In a total of 268 patients, i-SAH and o-ICH were found in 10.4% and 10.8%, respectively. NIHSS scores at admission were not significantly different among i-SAH, o-ICH and non-ICH groups. NIHSS scores of i-SAH patients at discharge were comparable to o-ICH patients (median 18 versus 21, p=0.578) and were significantly higher than non-ICH patients (18 versus 7, p=0.008). In patients experiencing complete reperfusion (TICI=3), i-SAH patients tended to have more severe neurological impairment than non-ICH patients (median NIHSS 10 versus 5, p=0.3), although NIHSS at discharge compared to admission decreased similarly between both groups (median reduction 5 versus 6, p=0.866). In patients with successful but incomplete reperfusion (TICI=2b), i-SAH patients showed significantly worse neurological outcomes at discharge than non-ICH patients (NIHSS 23.5 versus 8, p=0.03) and even deterioration of their neurological deficit after thrombectomy (NIHSS increase of 5 versus reduction of 4, p=0.017).

Conclusion

Post-thrombectomy i-SAH is an important complication as it might aggravate patient’s neurological impairment, particularly in case of incomplete reperfusion.

Disclosure of Interest

Nothing to disclose.